New scheduler makes bottlenecks disappear
Vendor sought provider input in design process
In the first five months after Northwest Community Hospital in Arlington Heights, IL, went live with the SMS NOVIUS Scheduling system in its outpatient oncology clinic, the clinic scheduled roughly 5,000 appointments from a database of 1,800 patients, says Ruth McCallum, RN, clinical applications consultant.
The system, which was scheduled to go live in four other areas beginning this month, tightened loose scheduling practices and policies and eliminated bottlenecks, backups, and one scheduling position, she says. Plans call for it to be installed throughout the local network, which includes the acute care hospital, a subacute care center, a wellness center, three freestanding treatment centers, and four physician office buildings.
The scheduling system has the potential to serve the entire Chicago-based Northwestern Healthcare Network, which includes nine hospitals and local health systems, McCallum adds. "Our vision into 2000 and beyond is to have a one-stop shopping environment, with one call to schedule, preregister, and, if needed, get precertification. We're looking for that [to occur] in the next three years."
Functional and user-friendly
Northwestern's scheduling system is connected to an enterprise access directory (EAD) at the SMS data center at the vendor's Malvern, PA, headquarters. SMS customers also may choose to have their EAD on site. That is what the Casey Eye Institute at Oregon Health Sci ences University, which also uses the NOVIUS system, chose to do. Thus far, these are the only two organizations that have gone live with this system.
The SMS product is notable because the company formed partnerships with providers early in the development process with the aim of designing a functional and user-friendly product, industry professionals say.
The system uses client-server architecture, as opposed to a traditional terminal-based mainframe. The client server, McCallum notes, allows for a better distributed processing environment. Rather than requiring the user to flip back and forth frequently between screens to perform different functions, which is common on mainframes, the SMS system puts as much information as possible into a few screens, making it easier to use. "With a mainframe, the system is harder to manage and doesn't have [as much] functionality. It's difficult to modify and to have unique rules for the different areas."
The internal architecture is three-tiered, explains Pete Colbert, development manager for NOVIUS Scheduling. Processing takes place at a workstation with a display that has been made "as intuitive and graphical as possible," he says. "The second tier is an NT-based server from Microsoft, which means low-cost processing, relatively inexpensive computing power, an industry standard."
In addition, Colbert notes, the system is "very scalable. You can start small and run the whole application on a single PC if needed, or you can scale up to process several million a year." The third tier, he says, is a Microsoft SQL database, which he describes as "vanilla Micro soft," that stores the appointments, the physician database, and a list of services offered across the enterprise.
Depending on the scale, the cost of hardware can range from $15,000 to several hundred thousand dollars, Colbert says.
SMS, which already had a number of "very good, very mature" scheduling products on the market, decided to develop one that could serve an entire enterprise, he adds. "We realized that scheduling was central to the practice of patient access in the emerging enterprise delivery of health care. There's a desire to market the whole enterprise, and [health systems] need a system to support that."
The SMS scheduler ties multiple registration systems, all of which feed into the single EAD, Colbert explains. "If you call [for an appointment] and you haven't been seen in Hospital Y, but you have been seen in Hospital X, it can schedule you in Y."
Other features include the ability to find - from a single form - a doctor of internal medicine if the patient is indifferent about whom she sees, or a specific physician in that specialty. In both cases, Colbert says, "It's a one-step process. [The system] is able to respond quickly to whichever level."
He describes NOVIUS as "very much a hybrid system" that works well on the individual department level, as well as throughout the enterprise. "You may make your initial contact at the main 800 number but schedule follow-ups at a specific department."
Required thinking cut in half
The beauty of an integrated health network (IHN) scheduling system is that it halves the thinking that's required of schedulers, explains Martine Saber, director of admitting for Baycare Health System in Clearwater, FL.
"When you build it, you put in all your rules," she says. "If the patient needs a CAT scan along with the cancer treatment, it automatically knows how long it will take to get from one facility to another. It knows how to schedule a fasting vs. a non-fasting exam. It schedules so the scheduler doesn't have to think."
Saber knows firsthand the potential benefits of an IHN scheduling system, thanks to time spent two years ago as an information systems project manager when Morton Plant Mease Health Care, now part of the Baycare system, served as a beta test site for the SMS scheduling project.
Customer-focused software
Despite the project's potential, Morton Plant Mease ultimately pulled out of the partnership with SMS because of bugs that still had to be worked out of the system, she says.
"We had to give up the project, because [the system] just wasn't ready, it hadn't been perfected." But, she adds, "It was the perfect sched ul ing system, because [SMS] got a bunch of hospitals together and said, `What do you want?' and we told them, and it was a lot. To build it took a lot of time."
Saber and a co-worker were among several customers brought in, some a number of times, to test the SMS scheduling system in Pennsylvania.
"We created screens, let [the customers] review them on-line and then adjusted [the screens] to make sure the work flow matched their work flow," Colbert adds. "We involved the end user in the actual design."
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